Use of Emergency Medical Service transport system in medical patients up to 36 months of age

Objectives: To determine the frequency of inappropriate transport by Emergency Medical Service (EMS), Design: A retrospective study. Subjects: Patients up to 36 months of age with medical complaints transported by EMS to an urban pediatric emergency department (ED), Interventions: None. Measurements: Arbitrary criteria for appropriate use of EMS transport system were developed. The age, triage status, number of previous uses of EMS, health insurance status, time of calls, chief complaint, and clinical management of patients in the ED were determined. The frequency of inappropriate use of EMS was determined and also the percentage of patients up to 36 months of age who used EMS transport system on more than one occasion. Results: Charts of 341 patients were reviewed of which 126 patients (37%) could have been transported by nonemergent vehicles according to our arbitrary criteria. In addition 97 (28%) of these patients had used the EMS transport system on at least one other occasion. Conclusions: EMS is utilized for inappropriate transportation in approximately 37% of our pediatric patients less than 36 months of age with medical complaints. In addition, 28% of these same patients utilized the EMS system on more than one occasion. It would appear that education of care providers in the appropriate use of EMS and use of alternate means of transportation would make the system more efficient and productive.